Pharmacologic control of ventricular rate

American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery

Elizabeth A. Martinez, Andrew E. Epstein, Eric B Bass

Research output: Contribution to journalArticle

Abstract

While there is a deficiency in the number of randomized control studies dealing with the pharmacologic control of the ventricular response to atrial fibrillation (AF) or a trial flutter (AFL) after cardiac surgery, evidence-based recommendations are presented from those studies that are available. Because of the hyperadrenergic state after surgery, beta-blockers are recommended as the first line of therapy for patients with AF or AFL who do not require urgent cardioversion. Calcium channel blockers are recommended as second-line therapeutic agents. Digoxin has little efficacy because of the heightened adrenergic tone that is present postoperatively. Agents that are proarrhythmic, such as dofetilide, or agents that are contraindicated in patients with coronary artery disease, such as flecainide and propafenone, are not recommended.

Original languageEnglish (US)
JournalChest
Volume128
Issue number2 SUPPL.
DOIs
StatePublished - Aug 2005

Fingerprint

Atrial Fibrillation
Thoracic Surgery
Guidelines
Propafenone
Flecainide
Electric Countershock
Digoxin
Calcium Channel Blockers
Adrenergic Agents
Coronary Artery Disease
Therapeutics
dofetilide

Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Cardiopulmonary bypass
  • Coronary artery bypass graft
  • Rapid ventricular response

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Pharmacologic control of ventricular rate : American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. / Martinez, Elizabeth A.; Epstein, Andrew E.; Bass, Eric B.

In: Chest, Vol. 128, No. 2 SUPPL., 08.2005.

Research output: Contribution to journalArticle

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